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Jul 24 06 01 : 13p Ponder Enviro Service Inc 707-748-7776 p. 3 <br /> geaport Environmental - Acce ice Procedure - Wastewater Characteri )n Form Page 2 of 2 <br /> Can you detect an hydrocarbon odor from the wastewater? YesV No_ <br /> Y Y Y / <br /> Was the wastewater tested for hydrocarbons? Yes_ N <br /> Is there any reason to suspect the presence of chlorinated hydrocarbons such as Yes_ No <br /> S trichloroethylene? <br /> Was the wastewater tested for chlorinated hydrocarbons ? Yes_ No_ <br /> Is there any reason to suspect the presence of heavy metals, such as lead? Yes_ Nov <br /> Was the wastewater tested for heavy metals?lf"Yes", please describe tests and attach Yes_ Nov <br /> copies of the test results. <br /> Was the wastewater tested for anything other than the above contaminants? Yes_ No <br /> If"Yes", please describe tests and attach copies of the test results. <br /> Is there any other analytical test data (eg soil samples)for this site? Yes_ No_ <br /> Is there any soil vapor monitoring data for this site? Yes_ No <br /> Please describe the appearance of the waste water. <br /> Color <br /> Estimated amount of sediment(%wt) <br /> Is there evidence of an emulsion? Yes_ No_ <br /> Estimated Volume of waste water(USG) s Q a C> <br /> Generator's Certification that Wastewater is Non-Hazardous <br /> DESCRIPTION OF WATER: CERTIFY THAT THE ABOVE NAMED MATERIAL IS A LIQUID EXEMPT <br /> FROM RCRA PER 40 CFR 261.4(b)(10)AND DOES NOT MEET THE CRITERIA OF HAZARDOUS <br /> WASTE AS DESCRIBED IN 22 CCR ARTICLE 11 OR ANY OTHER APPLICABLE STATE LAW, HAS <br /> BEEN PROPERLY DESCRIBED, CLASSIFIED AND PACKAGED AND IS IN PROPER CONDITION <br /> FOR TRANSPORTATION ACCORDING TO APPLICABLE REGULATIONS. <br /> The information and representations presented above are true and correct to the best of my knowledge. <br /> /,,, — —o <br /> Generator/Authorised Agent Signature& Date Approval# <br /> Approval# <br /> http://www.seaportenvironmental.com/wastewater—form.htm 7/24/2006 <br />